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超声引导下高强度聚焦超声治疗乳腺纤维瘤的长期疗效

Long-term efficacy of ultrasound-guided high-intensity focused ultrasound treatment of breast fibroadenoma.

作者信息

Kovatcheva Roussanka, Zaletel Katja, Vlahov Jordan, Stoinov Julian

机构信息

Department of Thyroid and Metabolic Bone Disorders, University Hospital of Endocrinology, Medical University of Sofia, 2, Zdrave Street, 1431 Sofia, Bulgaria.

Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.

出版信息

J Ther Ultrasound. 2017 Mar 16;5:1. doi: 10.1186/s40349-017-0083-1. eCollection 2017.

Abstract

BACKGROUND

To assess the long term efficacy and tolerability of one or two ultrasound (US)-guided high-intensity focused ultrasound (HIFU) treatment in patients with breast fibroadenoma (FA).

METHODS

Twenty patients with 26 FA were selected for US-guided HIFU. The therapy was performed in one or two sessions. FA volume was assessed before and followed up to 24 months after the last HIFU. After each treatment, adverse events were evaluated.

RESULTS

In 19/26 FA (73.1%) one HIFU was performed (group 1), whereas 7/26 FA (26.9%) received second HIFU (group 2) 6-9 months (median, 7 months) after the first session. In group 1 and 2, FA volume decreased significantly at 1-month ( < 0.001) and 3-month follow-up ( = 0.005), respectively, and continued to reduce until 24-month follow-up ( < 0.001 and  = 0.003, respectively). At 24 months, mean volume reduction was 77.32% in group 1 and 90.47% in group 2 ( = 0.025). Mild subcutaneous edema was observed in 4 patients and skin erythema in 3 patients.

CONCLUSIONS

US-guided HIFU represents a promising non-invasive method with sustainable FA volume reduction and patient's tolerability. Although one treatment is highly efficient, the volume reduction can be increased with second treatment.

TRIAL REGISTRATION

NCT01331954. Registered 07 April 2011.

摘要

背景

评估超声(US)引导下高强度聚焦超声(HIFU)单次或两次治疗乳腺纤维瘤(FA)患者的长期疗效和耐受性。

方法

选取20例患有26个乳腺纤维瘤的患者接受超声引导下的高强度聚焦超声治疗。治疗进行一次或两次。在最后一次高强度聚焦超声治疗前及随访至24个月时评估乳腺纤维瘤体积。每次治疗后评估不良事件。

结果

26个乳腺纤维瘤中的19个(73.1%)接受了单次高强度聚焦超声治疗(第1组),而26个乳腺纤维瘤中的7个(26.9%)在第一次治疗后6 - 9个月(中位数为7个月)接受了第二次高强度聚焦超声治疗(第2组)。在第1组和第2组中,乳腺纤维瘤体积分别在1个月(<0.001)和3个月随访时(=0.005)显著减小,并持续减小直至24个月随访(分别为<0.001和=0.003)。在24个月时,第1组平均体积缩小77.32%,第2组为90.47%(=0.025)。4例患者出现轻度皮下水肿,3例患者出现皮肤红斑。

结论

超声引导下的高强度聚焦超声是一种有前景的非侵入性方法,可使乳腺纤维瘤体积持续缩小且患者耐受性良好。虽然单次治疗效率很高,但二次治疗可进一步增加体积缩小率。

试验注册

NCT01331954。于2011年4月7日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d9a/5353785/138855478565/40349_2017_83_Fig1_HTML.jpg

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